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Preheat oven to 375 degrees F. Spray a 3 quart baking dish with cooking spray.
Add cream of mushroom soup and water to the prepared dish. Whisk together until completely combined.
Stir in uncooked rice, tomatoes, bell pepper, and onion. Season with about ½ teaspoon salt and ¼ teaspoon pepper. Stir again.
Cover tightly with foil and bake for 30 minutes. Remove from oven and stir in sausage. Cover again, return to oven, and bake for 30 more minutes.
At this point, give the casserole a stir and check the rice for doneness. If the rice isn’t completely tender, cover the dish and continue baking for 10-15 more minutes, or until most of the liquid is absorbed and rice is cooked.